3D OPTICAL IMAGING AND DIGITAL XRAY OF
BREAST LESIONS
Qianqian Fang, Stefan Carp, Mark Martino,
Richard Moore,
Daniel Kopans, David Boas
Optics Division, Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Harvard Medical School
μM
A
F
F
T
T
TOMO slice
NIH R01-CA97305, R01-CA142575
A
HbT
Fang et al Radiology 2011
Outline
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Background
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Technology development
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Combined optical and tomosynthesis imaging system
Multi-modality imaging data analysis
Clinical trials and findings
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Motivation and goal
A multi-modality approach
Imaging healthy subjects
Imaging malignant and benign lesions
Statistical group analysis
Conclusions
Breast cancer fact sheet
• Second leading cause of death for women in the US
• Accounting for 15% female cancer death
• Early detection is critical
Multi-modality Imaging
• Complex nature of diseases requires more diagnostic information
• Combine structural and functional imaging
PET & CT
PET & MRI
http://en.wikipedia.org/wiki/Positron_emission_tomography
Optical & Mammography
Combined TOBI & DBT system
Tomographic Optical Breast Imaging
• Multiplexed RF lasers: 40 (685/830nm)
• Multiplexed CW lasers: 150 positions (685/810/830nm)
• Frequency-encoded (FE) CW lasers: 26 (685/830nm)
For 45 seconds: we run all FE CW at 20Hz, 7 repetitions
for 22 MUX CW positions and 2 repetition for RF
Digital Breast Tomosynthesis
• Position breast
• Compress
• Take optical measurement (45s)
• Remove optical probes
• Take DBT scan (2s)
Duration: Approx 90s
Spatial vs. Temporal
Resolution
0
20
40
Signal Intensity (A.U.)
Signal Intensity (A.U.)
Motivation for dynamic imaging
60
Time (s)
0
20
40
Signal Intensity (A.U.)
Time (s)
0
20
40
60
Time (s)
Signal level drops up to 10% during 45 seconds of measurement
Dynamic process leads to increased absorption
60
Processing pipeline
DBT Image
reconstruction
Optical/X-ray
Registration
Mesh generation
Optical Image
reconstruction
15 Projections over ±22.5° (MLEM Recon)
Processing Pipeline
DBT Image
reconstruction
Optical/X-ray
Registration
Mesh generation
Optical Image
reconstruction
Processing Pipeline
DBT Image
reconstruction
Optical/X-ray
Registration
Mesh generation
Optical Image
reconstruction
Processing Pipeline
DBT Image
reconstruction
Optical/X-ray
Registration
Mesh generation
Optical Image
reconstruction
Outline

Background and significance


Motivations and goals
A multi-modality approach
 Technology development



Clinical trials and findings




Combined optical and tomosynthesis imaging system
Multi-modality imaging data analysis
Imaging healthy subjects
Imaging malignant and benign lesions
Statistical group analysis
Conclusions
Sample optical images – Healthy I
37 yr old woman, right breast
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C
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F
TOMO slice
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F
HbT
Spatial vs. Temporal
Resolution
Fang Q, et al.,” IEEE Trans. Medical Imaging, vol. 28, issue 1, pp. 30 – 42, Jan. 2009.
Sample optical images – Healthy I
37 yr old woman, right breast
1/cm
μM
C
C
C
A
F
TOMO slice
C
A
A
F
F
HbT
fibroglandular/adipose:
1.42
StO2
1.02
A
F
Scat. Coeff (830nm)
1.28
Reconstructed images – Malignant
45 yr old woman, right breast
2.5 cm IDC with a large portion of DCIS
μM
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1/cm
A
A
A
F
F
F
F
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TOMO slice
HbT
fibroglandular/adipose: 1.55
tumor/adipose:
2.07
StO2
1.00
0.99
Scat. Coeff (830nm)
1.04
1.09
More malignant lesions (HbT Images)
Age=77, R-side IDC grade 3, 0.7cm
Age=79, L-side IDC, 2.5cm
Age=45, R-side, IDC 2.5cm
Age=42, L-side 2cm mass
(invasive mammary carcinoma)
ROI analysis and statistical tests
Solid Benign Lesions: Fibroadenomas
39 years old woman: 16mm fibroadenoma
HbT (μM)
HbT (μM)
42 years old woman: 8mm fibroadenoma
Benign Lesions: cysts
Left breast of a 49-year-old woman
Two cysts 29x11x26mm and 12x9x5mm at the pointed locations
(μM)
TOMO slice
HbT
1/cm
StO2
Scat. Coeff (830nm)
ROC – Malignant vs Benign
n=25
n=8
n=17
AUC = 0.74
AUC = 0.75
• Structural priors in Optical Imaging Reconstruction
• Spatio-Temporal Resolution
• Novel Biomarkers from Dynamics
ROC – Cyst vs Malignant
AUC = 0.83
AUC = 0.86
Impact patient work flow for follow-up US
Compositional Prior
DBT
Cf
HbT binary
HbT Compositional Prior
Fang BOE 2010
HbT normal
Compositional Prior
DBT
HbT comp
HbT normal
Fang BOE 2010
DBT
HbT comp
HbT normal
Residual comparable or reduced… degeneracy of ill-posed reconstruction
Prior improves symmetry of optical properties between left and right breasts!
Compositional Prior - Tumors
Still only 2 components – Fibroglandular and Adipose
μM
A
1/cm
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A
F
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F
F
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TOMO slice
Stats about
the same as
without prior
HbT
StO2
Scat. Coeff (830nm)
Compositional Prior - Tumors
Add a 3rd component, a gaussian
sphere for Lesion
HbT
2 Component
HbT
3 Component
2 Component
3 Component
Summary
μM
A
F
F
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T
Signal Intensity (A.U.)
TOMO slice
0
20
40
Time (s)
60
A
HbT
• HbT differentiates malignant from benign
• SO2 & HbT differentiates Cysts
• Composition Priors expected to offer
improvements
• 60 more lesion cases being analyzed
now!
• 2nd Generation with TechEn Inc. and
Philips Medical (NIH AIP and Mass Life
Science Center)